Is an incomplete miscarriage painful?

Having an incomplete miscarriage can be a painful and difficult experience both physically and emotionally. An incomplete miscarriage occurs when a pregnancy ends on its own before 20 weeks, but not all of the tissue has passed from the uterus.

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What are the symptoms of an incomplete miscarriage?

The main symptoms of an incomplete miscarriage include:

Vaginal bleeding – This may range from light spotting to heavy bleeding. The blood may contain clots or tissue.
Cramping and pain – Many women experience strong cramping that feels like intense period cramps or labor contractions. The pain may come and go.
Tissue passing from the vagina – You may pass large clots, pieces of gray or pink tissue, or the intact gestational sac.

No longer experiencing pregnancy symptoms – Symptoms like nausea, fatigue, and sore breasts will diminish.

Some women do not experience any pain with an incomplete miscarriage while others find it quite painful. The level of pain and discomfort can vary greatly from person to person.

What causes the pain with an incomplete miscarriage?

There are several reasons why an incomplete miscarriage can be painful:

Uterine cramping – The uterus contracts to try to expel any remaining tissue, causing strong cramping pains similar to menstrual cramps or labor contractions.
Dilation of the cervix – As the cervix opens to allow the passage of tissue, this can cause cramping and aching sensations.
Bleeding – Heavy bleeding can cause cramping, clots and discomfort.

Irritation – Any remaining tissue left in the uterus can cause irritation and cramping.
Emotional factors – The profound sadness and anxiety associated with losing a pregnancy can magnify the physical discomfort.

How long does the pain last?

The duration of the pain and cramping associated with an incomplete miscarriage varies depending on the individual situation. Here is an overview:

Many women experience painful cramping and bleeding when the miscarriage first begins. This may last from several hours to a couple days.
Ongoing pain can occur if tissue remains in the uterus and the body continues trying to expel it. This can last anywhere from days to weeks.
Once all the tissue has passed, the pain and bleeding tends to taper off within a week or two for most women.

If tissue remains in the uterus for longer than 2-3 weeks, the pain may come and go until the miscarriage completes.
Taking medication or having a D&C procedure can help speed up the completion of the miscarriage and resolve any lingering pain.

How is an incomplete miscarriage treated?

There are three main options for treating an incomplete miscarriage:

Wait for the miscarriage to complete naturally. This involves letting the rest of the tissue pass on its own. Pain medication can help manage cramps and discomfort. For some women the process completes within days, while for others it takes weeks.
Take medication to expel the tissue. Medicines like misoprostol cause uterine contractions to help the body pass the remaining tissue. This speeds up the completion of the miscarriage. Pain and cramping often increase when the medication is taken.
Have a D&C (dilatation and curettage) procedure. During a D&C the doctor uses gentle suction and/or instruments to remove any tissue left behind. This provides quick relief from symptoms. You are given anesthesia so you do not feel pain during the procedure. Mild cramping can occur afterwards as the uterus heals.

Your doctor can discuss the pros and cons of each option to help you decide the best course of treatment. The choice may depend on factors like how much bleeding and pain you are having, availability of an operating room, and personal preference.

Pain management for an incomplete miscarriage

Whether you decide to let the miscarriage complete naturally or opt for medical/surgical management, there are things you can do to help ease the discomfort:

Over-the-counter painkillers – Medications like ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) can help relieve cramping.

Heating pads – Applying heat to the lower abdomen may reduce cramping and provide comfort.
Warm baths – Soaking in a warm bath can help soothe the body during this difficult process.
Rest – Getting lots of rest allows the body to focus its energy on healing.

Healthy diet – Eating a balanced diet and staying hydrated can support the recovery process.
Emotional support – Having supportive family/friends to talk to can help cope with the physical and emotional pain.
Medications – Your doctor may prescribe stronger painkillers or anti-cramping drugs to give more relief if needed.

Don’t hesitate to ask your healthcare provider about options to make passing the miscarriage tissue as comfortable as possible. Finding ways to ease the pain can help you get through this difficult process.

When to seek emergency care

In most cases, you can manage the pain and bleeding of an incomplete miscarriage at home. However, you should seek prompt medical care if you experience:

Heavy bleeding that soaks through more than 2 pads per hour

Severe pain not relieved by medication
Fever over 100.4°F (38°C)
Fainting or dizziness

Foul-smelling vaginal discharge

These symptoms could indicate a complication like infection or excessive blood loss. Call your doctor right away or go to the nearest emergency room for evaluation. Prompt treatment is needed to prevent serious problems.

Emotional pain of an incomplete miscarriage

In addition to physical pain, incomplete miscarriages can take a heavy emotional toll. The loss of a wanted pregnancy is devastating. It’s normal to experience profound grief and a wide range of difficult feelings such as:

Shock and disbelief
Anger or irritability
Guilt and self-blame

Intense sadness and crying
Loneliness
Anxiety

Sense of emptiness

There is no right or wrong way to feel after this kind of loss. Be gentle with yourself and take time to grieve. Reach out for support from loved ones, support groups, counseling, or other resources. With time and support, the intense pain will gradually subside and transform into healing.

Coping tips for the emotional pain

Some strategies that may help you cope with the emotional aftermath of an incomplete miscarriage include:

Allow yourself to fully grieve – Cry, scream, journal, do whatever helps you express the depth of your feelings.
Commemorate your baby – Do something meaningful like holding a ceremony, planting a tree, or making a donation in their memory.
Be kind to yourself – Eat well, rest, lower expectations of yourself, and avoid negative self-talk.

Seek counseling – A therapist can give you a safe space to process this loss and develop coping skills.
Join a support group – Connecting with others who’ve had similar losses can help you feel less alone.
Express yourself creatively – Writing, art, music, and dance can be cathartic outlets for your emotions.

Consider journaling – Writing down thoughts, feelings, hopes, fears can help you gain perspective.
Find meaning in small joys – Notice little moments of beauty, humor, or connection amidst the pain.

Be patient and take all the time you need to grieve in your own way. With support, the intense sorrow will gradually lessen and you can emerge stronger.

When to seek help for emotional distress

It’s normal to feel overwhelmed by grief after pregnancy loss. But if feelings of depression, extreme hopelessness, or trauma do not start to improve after a few weeks, you may benefit from professional mental health support. Seek help from your doctor or a therapist if you experience:

Depression that makes it extremely difficult to function
Thoughts of suicide or self-harm

Flashbacks, panic attacks, or severe anxiety interfering with daily life
Using drugs, alcohol or risky behaviors to numb the emotional pain
Intense guilt, shame, or anger that won’t subside

Withdrawal from family/friends and inability to experience joy

You deserve support and compassion as you grieve this loss. Don’t hesitate to reach out for help managing the emotional pain so you can ultimately heal.

Physical recovery after an incomplete miscarriage

It usually takes at least a couple weeks for the body to physically recover after an incomplete miscarriage. Here’s an overview of what to expect:

Bleeding – Bleeding similar to a heavy period often lingers for up to 2 weeks. It slowly tapers off and changes to brownish discharge before stopping.
Cramps – Milder cramps and discomfort may come and go as the uterus shrinks back to normal size.
Hormone changes – HCG and progesterone drop back to pre-pregnancy levels within a couple weeks.

Breast changes – Tenderness and engorgement subside as hormone levels decline.
Fertility return – Most women ovulate again 2-4 weeks after the miscarriage completes.
Normal periods – Regular menstrual cycles often resume within 1-3 months.

Follow-up exams – Your doctor will want to see you 1-2 weeks later to ensure all tissue passed.

Give your body the time it needs to recover by resting, eating nutritiously, staying hydrated, and avoiding strenuous activity for a while. Call your doctor if bleeding lasts longer than 2 weeks or you have signs of infection like fever or foul-smelling discharge.

When is it safe to try conceiving again?

Most doctors recommend waiting until after at least one normal menstrual cycle before trying to get pregnant again. This allows time for:

The uterus to heal from the miscarriage
Hormone levels to return to normal
The menstrual cycle to resume its regular rhythm

The date of conception to be calculated more easily
Emotional recovery from the loss

However, there is little medical evidence that getting pregnant right away increases risks. Some couples may be emotionally ready to start trying again sooner. It’s very individual, so do what feels right for you and your partner.

What are the chances of having a successful pregnancy after miscarriage?

Most women can have a healthy pregnancy after an incomplete miscarriage. Some statistics to provide hope:

After 1 miscarriage, 75% of women have a normal next pregnancy.
After 2 consecutive miscarriages, 65-70% of women go on to have a healthy baby.

At age 35, 78% will deliver after their next pregnancy.
At age 40, 65% will deliver their next baby.

Talk to your doctor if you have multiple losses in a row so testing can be done to identify any underlying causes. Treatment may improve your chances for a take-home baby.

Tips for getting pregnant again after miscarriage

Steps you can take to promote conception include:

Take a prenatal vitamin with folic acid
Eat a balanced diet and stay active

Avoid smoking, drugs, and excess alcohol
Record your menstrual cycles and check for ovulation
Have sex every 2-3 days during your fertile window

Reduce stress and make time for intimacy
Seek testing/treatment for any identifiable issues
Consider seeing a fertility specialist if you don’t conceive after 3-6 cycles

Remember to be patient and kind to yourself. With time and care, most women can welcome a healthy baby into their lives after miscarriage.

Conclusion

An incomplete miscarriage can cause substantial physical pain and emotional grief. Allow yourself to feel whatever emotions arise and reach out for support. Take things slowly and be gentle with yourself as you heal. For most women, the pain gradually subsides and the body recovers its strength. With hope, time, and care, the sadness can make way for joy when the time is right to try for a baby again. Take it step by step, honoring the process of grieving while also nurturing your body, heart, and spirit.